Last Updated: 2008-03-12 14:43:24 -0400 (Reuters Health)
NEW YORK (Reuters Health) – Selective serotonin reuptake inhibitors are more effective than placebo for obsessive compulsive disorder, according to a review of clinical evidence published in the latest issue of the Cochrane Database of Systematic Reviews.
"Obsessive compulsive disorder is a common and disabling disorder," write Dr. G. Mustafa Soomro, of the University of London, UK, and colleagues. "Individual randomized controlled trials have shown that selective serotonin reuptake inhibitors (SSRIs) are effective in this condition," they note. "Previous systematic reviews or meta-analyses summarizing the evidence are methodologically problematic or limited in the scope of their analysis."
The researchers identified 17 randomized controlled trials involving 3097 participants that examined the efficacy of SSRIs compared with placebo for OCD in adults, and that met inclusion criteria. The SSRIs included fluoxetine, fluvoxamine, sertraline, paroxetine, and citalopram.
Based on pooled data from all 17 studies, SSRIs as a group were more effective than placebo in reducing obsessive compulsive disorder symptoms between 6 and 13 weeks post-treatment (weighted mean difference on the Yale-Brown Obsessive Compulsive Scale -3.21). All five drugs demonstrated a similar degree of benefit.
Based on 13 studies involving 2697 participants, SSRIs were more effective than placebo in achieving clinical response at post-treatment. The overall relative risk was 1.84, which was similar for individual SSRIs.
"Although reported adverse effect data were limited, with few exceptions, the overall and individual adverse effects for the different SSRIs were always worse than for placebo, and in the majority of cases, the difference was statistically significant," Dr. Soomro and colleagues report. "The most common adverse effect was nausea."
They conclude that while SSRIs seem more effective than placebo for OCD, "at least in the short-term," the longer term efficacy and tolerability have yet to be established.
Cochrane Database Syst Rev 2008;1.
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